The specific aim of this proposal is to create improved maxillofacial prostheses from cast titanium. Cast titanium offers a combination of biocompatibility and physical properties unmatched by any other metal in the implant armamentarium. The proposal calls for the development of anterior discontinuity defect (ADD) prostheses and midfacial resection scaffolding (MRS) by the application of special dental laboratory techniques available to the offerers. These techniques have been successfully used in the casting of removable partial dentures and crowns. Clinically accepted Branemark fixtures will be used for fixation of the ADD and MRS as well as to act as fiduciary markers to allow for control of dimensional change. Larger MRS structures will be cast in sections and argon welded. Standard metallurgical practice will be used to monitor any physical property changes or casting flaws encountered with either the vertical centrifugal or pressure/vacuum electric arc casting techniques. Appropriate aesthetic completion of the ADD and MRS will include casting of Ti pontics with polymer veneering in the former and acrylic palates and silicone extraoral prostheses in the latter. Success in Phase I will mean the development of all titanium frameworks with greater patient comfort and potential gains in aesthetics. Extension of cast techniques in Phase II may mean potential for replacing machined Ti devices and cast gold currently used with less expensive cast titanium, with overall increase in the commercial ability to custom cast titanium for prosthetics.